Goosby Gives Straight Talk on PEPFAR

“The President has every intention of keeping up with the $63 billion over six years,” that was promised for the Global Health Initiative (GHI) and the President’s Emergency Plan for AIDS Relief (PEPFAR), said Ambassador Eric Goosby, MD – the U.S. Global AIDS Coordinator, on Tuesday.

Goosby sat down with Global Health Council President and CEO Jeffrey Sturchio, MD, for a live webcast discussion specifically about PEPFAR.

Global AIDS Coordinator Eric Goosby speaks with Global Health Council President Jeffrey Sturchio and Cheryl Burton of the State Department on PEPFAR.

Although over the course of the past two years we’ve only seen small increases in PEPFAR funding, Goosby said, “We’ve been able to drop the cost of care about two-thirds in the past 18 months, freeing up resources.” And those resources can be redirected back into the care, treatment and prevention services PEPFAR provides. He also said the President’s cross-government freeze on hiring or expansion of programs not related to security is causing administrators to look at areas of synergy and efficiency, where money can be spent more wisely and go further.

“That’s not to say that there won’t be situations where resources are temporarily saturated or there are queues [for receiving antiretrovirals], but those are rational queues and only used when they have to be,” Goosby said. “It really is the exception in the PEPFAR family of countries.”

When asked about marginalized populations, Goosby agreed with Sturchio that that often stigma and ignorance prevent these hard-to-reach populations from accessing treatment and care. As for how these populations are treated in PEPFAR programs, Goosby said, “When governments are not willing to engage, we go through NGOs to bypass that, creating opportunities for marginalized communities to access care,” he said.

Sturchio also asked Goosby to comment on health systems integration. “Since PEPFAR supports some 67,000 service sites, this isn’t an easy task,” Sturchio said. But Goosby maintained that “As HIV care providers, we see a host of other issues… We have felt, to date, impaired in our ability to respond to the patient sitting in front of us,” who has HIV/AIDS but is now presenting with these other diseases. But integration of services helps in that regard and also creates economies of scale, he said. “When women come in for ARVs they can also get information on family planning and reproductive help. By integrating those two services, the money that PEPFAR is giving for HIV/AIDS is being extended for family planning. In the same clinic they can be screened for cervical cancer. Now a range of services are being offered. Multiply that by the tens of thousands of sites where people are coming for treatment, prevention, etcetera, and then you can see the power of that approach,” Goosby said.

The session was the fifth in a new video series at the State Department entitled “Conversations with America.” Cheryl Benton, deputy assistant secretary of state for the bureau of public affairs, moderated the live webcast, which streamed on DipNote, the State Department’s official blog. To watch the recording, click here